Data about AKI in pediatric allo-HSCT recipients is scarce and often equivocal. Identifying baseline factors associated with AKI may allow to discriminate patients with increased AKI risk.

Material and methods:

Retrospective chart review of pediatric patients who underwent allo-HSCT at Vilnius University Hospital during 2011-2017.AKI was defined using pRIFLE criteria with AKI stage I (50% decrease in baseline eGFR) or higher considered only. Glomerular filtration rate (eGFR) was estimated by Schwartz equation.

Results:

A total of 45 patients were included. AKI occurred in 24 (53.3%) patients. 14 patients had more than one AKI episode. The maximum AKI stage was I in 19 and F in five patients. The median (IQR) time to first AKI episode was 28.5 (9.25-42.25) days. One-year mortality was 25% and 14.3% in patients with and without AKI respectively (p=0.37). No differences in demographic, anthropometric and clinical characteristics were found between patients with and without AKI (table).

AKI (n=24)

No AKI (n=21)

P value

Median age, yrs

10 (4.75-13)

6 (2-14)

0.29

Male, %

18 (75%)

13 (61.9%)

0.34

HSCT indication

Hematologic malignancy, %

12 (50%)

14(66.7%)

0.26

Myeloablative conditioning, %

11 (45.8%)

10(47.6%)

0.9

Hematopoietic stem cell source

Bone marrow, %

19(79.2%)

18 (85.7%)

0.71

Donor type

Unrelated donor, %

17(70.8%)

16(76.2%)

0.69

Matched donor, %

21(87.5%)

17 (80.9%)

0.55

T-cell depletion, %

19 (79.2%)

18 (85.7%)

0.705

Median baseline BMI, kg/m2

17.8 (15.5-21.1)

17.1 (15.4-18.2)

0.25

Median baseline eGFR, ml/min/1.73 m2

206.4 (168.5-230.5)

209.6 (156.8-223.2)

0.45

Baseline comorbidity, %

5 (20.8%)

5 (23.8%)

0.81

Conclusions:

More than half of the patients developed stage I and higher AKI in our cohort and half of these patients developed AKI in the first month after allo-HSCT. Patients with and without AKI did not differ by baseline characteristics and had comparable 1-year mortality.